Weight Loss Chat

Thanks to Dr. Mickey Seger, a bariatric surgeon with BMI of Texas, for our online health chat today. For more information you can reach Dr. Seger and his medical staff at www.bmioftexas.com

Dr. Seger performing a band fill.

….

Question from Michelle
I’ve heard weight loss surgery can help with diabetes….is this true?

Dr. Seger: Yes, in many cases we can greatly improve or resolve someone’s diabetes (Type 2), especially with the gastric bypass procedure. It’s really incredible — Many of our gastric bypass patients leave the hospital and don’t need their diabetes medicine anymore. With the band, sometimes it takes a little longer but we can also greatly improve and/or resolve their diabetes. We’ve heard story after story from our patients who don’t take any diabetes meds any more – it costs a minimum of $10K a year to treat diabetes, so the surgery pays for itself pretty quickly.

….

Questions from Rosa
How do I know which procedure is right for me? They all sound pretty good!

Dr. Seger: At BMI of Texas, we perform the 3 primary weight loss surgery procedures (band, bypass & sleeve), so we (usually) let our patient choose the procedure they think is most compatible with their personality or lifestyle. For example, some people really want the dumping syndrome associated with gastric bypass (some patients get uncomfortably sick when they eat any form of sugar after surgery) because they want that “punishment” factor. Others prefer the band procedure because we aren’t rewiring their internal anatomy – but they need to come get band fills on a regular basis. In some cases, there are medical reasons why a patient requires a certain procedure, but that’s why we make everyone interested in surgery come to a seminar – so they can learn about all the surgeries we perform and choose the one that is right for them.

Rosa: How do you know if you qualify for surgery?

Dr. Seger: If you are approximately 50-100 pounds overweight, you may qualify for surgery. If your BMI is 35 or higher (and you have other complications related to your weight, like diabetes or sleep apnea), then you may qualify. Without complications, insurance companies usually require someone have a BMI of 40 or higher. The FDA is recommending patients w/ a lower BMI qualify for band surgery, but we haven’t seen the insurance companies adopt that yet.
….

Christi Henefield
What is the safest surgery?

Dr. Seger: A gastric Band (Lap band or Realize band) is safest on the day of surgery, sleeve however probably has the lowest long term risk. For more information on this consider attending one of our seminars or watch one online at www.bmioftexas.com – you’ll get an overview of the various kinds of weight loss surgery, how they differ, and how they work.

….

Question
What is the average weight loss for a person who has had gastric bypass?

Dr. Seger: 70% of the excess weight – and 85 % of those patients will keep the excess weight off long-term. There’s a reason it’s the gold standard for weight loss surgery procedures.

….

Question from Terri
Do most insurance companies cover the Sleeve weight loss procedure? Is there financing available?

Dr. Seger: Yes, many insurance companies (except Humana) now cover the sleeve procedure – and we’ve seen great results from our patients who’ve had it done. Financing is available if your insurance does not cover it – we have patient advocates at BMI of Texas who can help you with the financing options.

….

Cynthia Blackburn

My mother is 73 years old and is interested in gastric bypass. Is there an age limit for this procedure? What is the determining factor?

Dr. Seger: There’s not an exact age limit (we’ve seen some very healthy 70 yos and some very unhealthy 50 yos). If the person is otherwise healthy, it’s certainly something to consider (with the blessing of your primary care doctor).

….

Question from Al
How long have you been doing these surgeries? Which ones do you do? In addition, how much does it cost if I want to pay cash? I am interested in the lap band. How often do I have to go in for fills? Is it painful? Will I be able to fill my port and will it be visible?

Dr. Seger: I have been doing these surgeries for 7 years in San Antonio, We do gastric sleeve, gastric bypass, lap band, revisional surgery. Generally or a cash pay surgery costs from $10,000 to $16,000 depending on what surgery is taking place. Insurance does cover over 50% of Texans though and if you don’t have coverage we have many financing options available.

Band fills usually occur monthly for the first 6-12 months then less frequently thereafter.
Pain after lap band surgery is minimal. Most folks can go back to work after 2-4 days.
You port will not be visible however you can feel it if you press on your abdomen.

….

Question from Abby

I want to know how long I would have to be out of work if I have the surgery. I have very limited time off. How often do I have to come in for follow-ups? Will my insurance pay for those visits or how does that work? How will my follow up be after surgery? Will I have to take vitamins for a little while or how long? Where would I get them?

Dr. Seger: Band patients usually only miss 2-4 days of work, sleeve patients typically stay out a week, and bypass patients 2-3 weeks.

Follow-up appointments are more frequent for the band – usually monthly during the first year to make adjustments. We can do the fills here in our office, which patients like because it doesn’t take very long. Bypass and sleeve patients usually have 5 post-op visits in the first year.

Insurance that pays for the surgery definitely pays for the follow-up appointments. We have vitamins here at BMI of Texas which are specially made for weight loss surgery patients. We have a dietitian here too – she helps our patients learn about food choices/food portions – and appropriate nutrition (including vitamins).

….

Sherry Dwyer

What if my BMI does not qualify but I still need help losing weight?

Dr. Seger: Great question, Sherry. We have an excellent medical weight loss program for people who don’t qualify for surgery or want to lose some weight before surgery. Call our office at 615-8500 and make an appointment to see Dr.Jenny. You can also learn more about it on our website at www.bmioftexas.com

….

A few questions from Ms. Bulla:

Q: How many Sleeves has your practice done?

Dr. Seger: We’ve performed approximately 100 sleeve procedures.

Q: How do I know if I qualify for the surgery?

Dr. Seger: If your BMI is greater than 35, then you may qualify. We have patient advocates/insurance specialists at our office who can help you figure out what your insurance will/won’t cover.

Q: How long does it take for the whole process before I can have surgery?

Dr. Seger: Depends on the kind of insurance you have. If you are paying out of pocket, we can get you ready for surgery in just a couple of weeks. But if you are working through an insurance provider, then you’ll have to comply with their requirements, which can make the process take longer.

Dr. Seger: Band procedures are now usually outpatient, but gastric bypass and sleeve procedures require a 2-3 night hospital stay.

….

Question: Which surgery is the most effective?

Dr. Seger: We believe that in most cases, the kind of surgery you have is a personal decision. Some people want to lose weight fast (gastric bypass) while others want a less invasive procedure (gastric band). That’s why we perform the three most common procedures (band, bypass and sleeve gastrectomy) – so our patients can choose the procedure that’s right for their lifestyle. In some cases, there’s a medical reason why one procedure is better than another, but usually it’s up to the patient.
…..

Question: Who’s a candidate for surgery these days?

Dr. Seger: Most insurance companies will cover surgery if your BMI is greater than 40 or if it’s greater than 35 and you are suffering from at least 1 co-morbidity (like diabetes, sleep apnea, etc.) The FDA has recommended the band procedure for patients with a lower BMI (35 and 30) but the insurance companies haven’t followed that recommendation (yet).